From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

From the Department of Neurology, Stroke Program (D.B.Z.) and the Departments of Epidemiology and Biostatistics (J.J.W.), School of Public Health, University of Michigan, Ann Arbor, MI; the Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI (D.F.E.); the Department of Neurology and Stroke Center, Georgetown University, Washington, DC (R.S.M., I.A.S., L.G., C.S.K.); Medstar Health Research Institute, Hyattsville, MD (S.J.F., N.M.S.); the Department of Radiology and Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH (R.E.B.); the Department of Neurology, Howard University, Washington, DC (A.J.T.); Johns Hopkins University Urban Health Institute, Baltimore, MD (M.C.G.); and the Department of Health Evidence and Policy, Division of Social Epidemiology; Department of Neurology, Mount Sinai School of Medicine, New York, NY (B.B.-A.).

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Abstract

Background and Purpose—Hypertension is the most important risk factor associated with intracerebral hemorrhage. We explored racial differences in blood pressure (BP) control after intracerebral hemorrhage and assessed predictors of BP control at presentation, 30 days, and 1 year in a prospective cohort study.

Methods—Subjects with spontaneous intracerebral hemorrhage were identified from the DiffErenCes in the Imaging of Primary Hemorrhage based on Ethnicity or Race (DECIPHER) Project. BP was compared by race at each time point. Multivariable linear regression was used to determine predictors of presenting mean arterial pressure, and longitudinal linear regression was used to assess predictors of mean arterial pressure at follow-up.

Results—A total of 162 patients were included (mean age, 59 years; 53% male; 77% black). Mean arterial pressure at presentation was 9.6 mm Hg higher in blacks than whites despite adjustment for confounders (P=0.065). Fewer than 20% of patients had normal BP (<120/80 mm Hg) at 30 days or 1 year. Although there was no difference at 30 days (P=0.331), blacks were more likely than whites to have Stage I/II hypertension at 1 year (P=0.036). Factors associated with lower mean arterial pressure at follow-up in multivariable analysis were being married at baseline (P=0.032) and living in a facility (versus personal residence) at the time of BP measurement (P=0.023).

Conclusions—Long-term BP control is inadequate in patients after intracerebral hemorrhage, particularly in blacks. Further studies are needed to understand the role of social support and barriers to control to identify optimal approaches to improve BP in this high-risk population.